Key result
Rotational atherectomy facilitates successful revascularization of a heavily calcified culprit lesion in acute anterior STEMI.
Why the study?
Does rotational atherectomy facilitate revascularization in acute STEMI with heavily calcified culprit lesions?
Case Report (n=1)
Does rotational atherectomy facilitate revascularization in acute STEMI with heavily calcified culprit lesions?
Rotational atherectomy can be successfully used to facilitate revascularization in acute STEMI with heavily calcified culprit lesions, despite traditional avoidance.
May support feasibility in select calcified STEMI cases; hypothesis-generating and should not change practice without prospective data.
BACKGROUND: Calcified coronary lesions represent technical challenges during percutaneous coronary intervention and are associated with a high frequency of restenosis and target lesion revascularization. Rotational atherectomy has been shown to increase procedural success in severely calcified lesions, facilitate stent delivery in undilatable lesions and ensure complete stent expansion. However, rotational atherectomy in ST-elevation Myocardial Infarction (STEMI) is traditionally avoided given the concern for slow or no reflow and considered a contraindication in lesions with a visible thrombus by its manufacturer (Rotablator, Boston Scientific). CONCLUSION: This case demonstrates the successful use of rotational atherectomy to facilitate dilation and revascularization of a heavily calcified culprit lesions in a patient with acute anterior STEMI with ongoing chest pain.
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Shahin et al. (2018) conducted a case report in Acute anterior STEMI with heavily calcified culprit lesion (n=1). Rotational atherectomy was evaluated on Successful dilation and revascularization. Rotational atherectomy successfully facilitated dilation and revascularization of a heavily calcified culprit lesion in a patient with acute anterior STEMI.
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